March 2019

Monthly Archive

Prevalence and predictors of complementary and alternative medicine modalities in patients with chronic hepatitis B.

Posted by on 27 Mar 2019 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Prevalence and predictors of complementary and alternative medicine modalities in patients with chronic hepatitis B. Liver Int. 2019 Mar 25;: Authors: Liem KS, Yim C, Ying TD, Zanjir W, Fung S, Wong DK, Shah H, Feld JJ, Hansen BE, Janssen HLA Abstract BACKGROUND & AIMS: The use of complementary and alternative medicine (CAM) in patients with chronic hepatitis B (CHB) can interact with antiviral treatment or influence health-seeking behavior. We aimed to study the use of individual CAM modalities in CHB and explore determinants of use, particularly migration-related, socio-economic and clinical factors. METHODS: A total of 436 CHB outpatients who attended the Toronto Centre for Liver Disease in 2015-2016 were included in this cross-sectional study. Using the comprehensive I-CAM questionnaire and health records, data were collected on socio-demographic and clinical variables and on usage of 16 CAM modalities in the last year. RESULTS: Sixty percent of patients were male, 74% were Asian and 46% were using antiviral treatment. Three-hundred nine (71%) patients used CAM. Vitamin/mineral preparations (45% of patients) were most commonly used. Overall CAM use and the specific use of potentially injurious CAM, such as green tea extract (9.2%) and St. John’s wort (0.2%), were not associated with liver disease severity. Female sex, family history of CHB, lower serum HBV DNA, and higher socio-economic status were independently associated with bio-holistic CAM use, the clinically most-relevant CAM group (p<0.05); ethnicity, antiviral therapy use and liver disease severity were not. CONCLUSIONS: CAM use among CHB patients was extensive, especially use of vitamin and mineral preparations, but without direct influence on liver disease severity. Bio-holistic CAM use appeared to be associated with socio-economic status rather than with ethnicity or liver disease severity. Despite the rare use of hepatotoxins, physicians should actively inquire about it. This article is protected by copyright. All rights reserved. PMID: 30912219 [PubMed – as supplied by publisher]

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Prevalence and predictors of complementary and alternative medicine modalities in patients with chronic hepatitis B.

Serum hepatocyte apoptosis biomarker predicts the presence of significant histological lesion in chronic hepatitis B virus infection.

Posted by on 21 Mar 2019 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Serum hepatocyte apoptosis biomarker predicts the presence of significant histological lesion in chronic hepatitis B virus infection. Dig Liver Dis. 2016 Dec;48(12):1463-1470 Authors: Cao ZJ, Li J, Wang Y, Bao R, Liu YH, Xiang XG, Lin LY, Ye FX, Lu J, Xie Q, Bao SS, Wang H Abstract BACKGROUND: Hepatocyte death, either apoptosis or necrosis, is closely associated with hepatic inflammation and fibrosis. AIMS: To investigate the potential values of hepatocytes death biomarker, M30 (apoptosis) and M65 (total death) in predicting histological lesions in chronic hepatitis B virus (HBV) infection. METHODS: Total 201 treatment-naïve patients were prospectively recruited. Liver biopsies were performed prior to antiviral treatments for treatments starting evaluation. Sera were collected on the day of liver biopsy for biomarker measurements. Sera from 200 age-matched healthy volunteers served as healthy controls (HCs). RESULTS: Significant histological lesions (SHL, i.e. significant inflammation and/or significant fibrosis) were confirmed in 150 (74.63%) patients. There were significantly higher serum M30 and M65 in patients with SHL than those without SHL (p<0.001) or than HCs (p<0.001). Serum M30, but not M65, independently predicted SHL [odds ratio:3.4 (95% CI, 1.8-6.2) per increase of 50U/L, p<0.001] after adjusting other potential confounding factors. A novel model based on M30 provided good diagnostic performance in predicting SHL [AUC, 0.87 (0.81-0.92)]. Cut-off value of >0 to confirm or ≤-0.5 to exclude SHL has ∼12% misclassification rate. CONCLUSION: Hepatocyte apoptosis biomarker, M30 is a promising non-invasive alternative to liver biopsy in chronic HBV infection upon treatment evaluation. PMID: 27575659 [PubMed – indexed for MEDLINE]

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Serum hepatocyte apoptosis biomarker predicts the presence of significant histological lesion in chronic hepatitis B virus infection.

Hepatitis C core antigen highly correlated to HCV RNA.

Posted by on 19 Mar 2019 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Hepatitis C core antigen highly correlated to HCV RNA. Kaohsiung J Med Sci. 2018 Dec;34(12):684-688 Authors: Chang C, Hung CH, Wang JH, Lu SN Abstract Hepatitis C virus core antigen (HCV-Ag) immunoassay has been proposed as a more cost and time efficient one-step alternative to the current two-step screening and diagnostic process. This study investigates the correlation between the HCV-Ag immunoassay and the current gold standard of Hepatitis C Virus (HCV) ribonucleic acid (RNA) molecular assay. Stored sera of 221 consecutive treatment-naive patients tested anti-HCV positive were selected to undergo both HCV-Ag immunoassay and HCV RNA molecular assay. Active infection status and HCV genotype were determined using both assays, and correlation was calculated using a logarithmic scale. Among 221 anti-HCV-positive sera, 197 were positive for both HCV Ag (≥3 fmol/L) and HCV RNA (>15 IU/mL), 22 were negative for both tests, while 2 were positive to HCV RNA only. The sensitivity and specificity for HCV Ag in predicting HCV RNA were 99% and 100%, respectively. Out of 199 patients (90%) tested positive for HCV viremia, 107 (56%) were of genotype 1, 77 (38.7%) of genotype 2 and 15 of other genotypes. Analysis of 221 anti-HCV-positive patient sera found a strong positive correlation between HCV RNA and HCV-Ag (r = 0.960, p < 0.001). Genotype 1 (log [HCV RNA] = 0.988 x log [HCV-Ag] + 2.768), with correlation coefficient 0.945, exhibited a stronger correlation than genotype 2 (log [HCV RNA] = 0.859 x log [HCV-Ag] + 2.859; r = 0.862). Given the strong positive correlation between HCV-Ag immunoassay and HCV RNA molecular assay in genotyping affected individuals, we propose that HCV-Ag immunoassay is a more cost and time efficient alternative to the current two-step diagnostic process. PMID: 30527202 [PubMed – indexed for MEDLINE]

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Hepatitis C core antigen highly correlated to HCV RNA.

Yinchenhao decoction for chronic hepatitis B: Protocol for a systematic review and meta-analysis.

Posted by on 07 Mar 2019 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Yinchenhao decoction for chronic hepatitis B: Protocol for a systematic review and meta-analysis. Medicine (Baltimore). 2019 Feb;98(8):e14648 Authors: Xu L, Xie T, Shen T, Jian S Abstract BACKGROUND: Chronic hepatitis B (CHB) is a very critical threat to public health worldwide, and is the primary cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). Yinchenhao decoction (YCHD) is a classic prescription of traditional Chinese medicine for the treatment of jaundice. Despite the satisfactory clinical efficacy of YCHD in the treatment of CHB, the safety of YCHD is still uncertain. Therefore, we will provide a systematic review of YCHD in CHB treatments. METHODS: The purpose of this review is to retrieve relevant literature on YCHD therapy for CHB in the electrical databases, including 4 Chinese databases (e.g., Wanfang database, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical database (CBM), Chinese Science and Technology Periodical database (VIP)) and 3 English databases (e.g., PubMed, Cochrane Library, and EMBASE). The literatures involved are from the establishment of the databases to January 2019. The primary outcomes are HBV-DNA, HBeAg, and ALT. We will calculate the data synthesis for meta-analysis using RevMan V.5.3 software if the results are suitable. RESULTS: This study will offer a high-quality composite of existing evidence for YCHD in CHB treatment according to HBV-DNA quantitative detection, HBeAg qualitative detection, ALT levels, TCM syndrome evaluation criteria, status changes in quality of life assessment participants, and adverse events. CONCLUSION: This systematic review will provide evidence to assess the clinical efficacy of YCHD in the treatment of patients with CHB. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019119720. PMID: 30813205 [PubMed – indexed for MEDLINE]

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Yinchenhao decoction for chronic hepatitis B: Protocol for a systematic review and meta-analysis.

Characterization of Hepatocellular Carcinoma Patients with FGF19 Amplification Assessed by Fluorescence in situ Hybridization: A Large Cohort Study.

Posted by on 01 Mar 2019 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Characterization of Hepatocellular Carcinoma Patients with FGF19 Amplification Assessed by Fluorescence in situ Hybridization: A Large Cohort Study. Liver Cancer. 2019 Feb;8(1):12-23 Authors: Kang HJ, Haq F, Sung CO, Choi J, Hong SM, Eo SH, Jeong HJ, Shin J, Shim JH, Lee HC, An J, Kim MJ, Kim KP, Ahn SM, Yu E Abstract Background: FGF19 amplification is a relatively novel type of genetic aberration that has been proposed to be a driver of hepatocarcinogenesis. Selective inhibitors of FGFR4, a receptor of FGF19, have been developed as targeted therapies for hepatocellular carcinoma (HCC). Despite the role of FGF19 in mediating HCC progression, the clinicopathological characterization of patients exhibiting FGF19 amplification remains unclear. Immunohistochemical staining is the simplest and most widely used method of identifying aberrations in the FGF19 gene, although its specificity is very low. Methods: This study investigated the prognostic significance of FGF19 amplification in a large cohort of 989 HCC patients using fluorescence in situ hybridization (FISH), which has a high degree of specificity. In addition, FISH data from formalin-fixed, paraffin-embedded sections were compared with copy number variation (CNV) data obtained from fresh frozen sections to validate the use of FISH as a diagnostic tool. Results: FGF19 amplifications were detected by FISH in 51 (5.15%) of the 989 patients, and were independently associated with poor survival and a higher risk of tumor recurrence, as well as with poor prognostic factors such as a high α-fetoprotein level, hepatitis B or C virus infection, a large tumor size, microvascular invasion, and necrosis. In addition, FGF19 amplification was associated with TP53 mutation, and was mutually exclusive with CTNNB1 mutation. The results of the FISH and CNV analyses exhibited a significant concordance rate of 96% (κ = 0.618, p < 0.001). Conclusions: These data indicate that FGF19 amplification represents a unique molecular subtype associated with poor prognostic characteristics, which supports the hypothesis that the FGF19-FGFR4 signaling pathway plays an important role in hepatocarcinogenesis. We have also demonstrated that FISH is a viable alternative to CNV analysis, offering a number of advantages in the clinical setting. PMID: 30815392 [PubMed]

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Characterization of Hepatocellular Carcinoma Patients with FGF19 Amplification Assessed by Fluorescence in situ Hybridization: A Large Cohort Study.